Funeral Services

Please complete this form with as much detail as possible to help us assist in planning of funeral services at Mount Pleasant Church and Ministries. Once submitted, our team will review your request and contact you shortly to discuss the next steps.

If you have any questions while filling out the form, contact us at 410-325-3080. Please note that charges may be applicable.

Requestor Information

First Name(Required)

Last Name(Required)

Email(Required)

Phone Number(Required)

Relationship to the Deceased(Required)

Are you or the deceased a member of MPCM?

Yes

If yes, who is the member?(Required)

Name of the Deceased

First Name(Required)

Last Name(Required)

Birthdate of the Deceased(Required)

Date of Passing(Required)

Deceased's Last Known Address (optional)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If known, please provide the last known address of the deceased.

Primary Point of Contact

Point of Contact(Required)

Is the primary contact the same as the requestor? If so, select "Yes".

Yes

Primary Point of Contact

First Name(Required)

Last Name(Required)

Primary Point of Contact Email (Optional)

Primary Point of Phone Number (Optional)

Point of Contact's Relationship to the Deceased (optional)

Funeral/Memorial Service Detail

Service Location(Required)

Would you like the service to be held at MPCM?

Yes

Funeral Home Name (Optional)

Funeral Home's Phone Number (Optional)

Type of Service(Required)

Funeral

Funeral and Interment

Memorial

Repast (Reception after the service)

Other

If the type is "Other", please explain: (optional)

Service Date Requested:(Required)

Service Time(Required)

This should include: The start time of the event. The estimated duration of the ceremony. Any additional time required for pre-ceremony activities (e.g., family hour, wake).

Estimated Number of Guests:(Required)

Are you also requesting a repast at MPCM?(Required)

Yes

If you are requesting to have a repast at the church, please note that availability is limited and subject to approval. This request does not guarantee the space or services will be available for a reception. Our team will review your request and discuss options with you if feasible.

Do you request a Pastor from MPCM to officiate the funeral?(Required)

Yes

An Officiant is responsible for keeping the order of the service (e.g., announcing prayer, songs, obituary reading)

Do you request clergy from MPCM to give the eulogy at the funeral?(Required)

Yes

An Eulogist is responsible for giving the sermon/words of comfort during the funeral and burial.

Preferred Location(s) on the MPCM property:(Required)

Chapel (up to 350)

Sanctuary (351 and up)

Grand Fellowship Hall (speak with bereavement personnel after selection)

Add Number Of Expected Attendees (Chapel)(Required)

Please enter a number from 1 to 350.

Add Number Of Expected Attendees (Sanctuary)(Required)

Please enter a number greater than or equal to 351.

speak with bereavement personnel after selection

Speak with bereavement personnel after selection

Additional Services Requested

Base services provided by MPCM: Audio/Visual (technical support, microphones, speakers), security, parking detail.

The following services are included with each event: audio/visual, custodial, and unarmed security/parking attendants. Additional services may incur extra costs.

Please select additional services as needed:

Additional services are based on availability. Charges may be applicable.

Live Streaming of Ceremony

Slideshow Presentation (provide files in advance)

Musician (keyboard player, organist)

Vocalist(s)

Access to Kitchen Facilities

Other

Other(Required)

If applicable, who will be responsible for payments to MPCM? (optional)

Please let us know about any additional requests or details we should be aware of:(Required)

Service at Another Location

Complete this section only if the event is not held at MPCM.

Name of the Location/Venue (optional)

(e.g., Funeral Home, Private Residence, Outdoor Venue, Burial Site)

Address of the Location (optional)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Location/Venue Contact Name (optional)

First Name

Last Name

Location Phone Number (Optional)

Location Email Address (optional)

Select the staff needed: (optional)

Eulogist

Officiant

If applicable, who will be responsible for payment to MPCM? (optional)

Additional Information

Additional Information (optional)

Is there any other information we should know about the deceased or the service?

Additional Information - Support/Counseling (optional)

Would you like follow-up support or grief counseling services?

Acknowledgment and Disclaimer

By submitting this form, I acknowledge and agree to the following:

Event Approval:
Submission of this request form does not guarantee that MPCM will host the requested event or provide all services listed. All requests are subject to review, availability, and alignment with MPCM's policies.
Services Requested:
Any additional services requested (e.g., sound/media, setup, security) are subject to approval and availability. MPCM will confirm which services can be provided after the request is reviewed.
Policies and Requirements:
I understand that I must comply with MPCM's policies, including any requirements for premarital counseling, liability insurance (if applicable), and adherence to facility rules.
Fees and Payments:
I acknowledge that all fees and payment terms will be provided upon approval of this request. A non-refundable deposit may be required to secure the booking, with full payment due by the specified deadline.
Cancellation and Changes:
I agree to notify MPCM immediately of any changes or cancellations. I understand that cancellation policies will apply once the booking is confirmed.

By signing below, I confirm that I have read and understood this acknowledgment and disclaimer.

Contact Person's Signature

Full Name(Required)

Signature(Required)

Your Name
Your Name
Your Name